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LouisianaHB 12362026 Regular SessionHouseWALLET

INSURANCE: Provides relative to pharmacy benefit managers reimbursements (EN +$2,265,844 SG EX See Note)

Sponsored By: Jason Brian DeWitt (Republican)

Signed by Governor

Insurance

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

Patients protected from pharmacy payment corrections

When pharmacy benefit managers make extra payments after claim errors, they cannot change the patient’s out-of-pocket share because of those payments. Beginning January 1, 2026, managers also cannot collect or take back professional dispensing fees from pharmacies, pharmacists, or health-plan members. That fee protection covers both retroactive claims from January 1, 2026, and future claims.

Pharmacies get appeals for payment errors

Beginning January 1, 2026, pharmacy benefit managers must offer pharmacies an appeal process for claim payment errors. Appeals must include a written wholesaler invoice showing the drug name, national drug code, purchase date, and cost. When a manager finds an error, it must make an extra payment bringing reimbursement up to the pharmacy’s acquisition cost. Louisiana’s insurance commissioner can require claims data, including payment amounts, dispensing fees, and adjustments, to check compliance.

Stronger payment rules for local pharmacies

Beginning January 1, 2026, pharmacy benefit managers must pay local pharmacies using National Average Drug Acquisition Cost, or wholesale acquisition cost when unavailable, plus a dispensing fee. Separately, the law defines a pharmacy’s acquisition cost as its documented purchase cost, never below the national average on the dispensing date. Without that average, acquisition cost uses invoice cost, or published wholesale acquisition cost without an invoice; managers cannot set it alone. The dispensing fee covers pharmacy services and overhead and must meet Louisiana Medicaid’s fee level; the reimbursement requirement excludes the Office of Group Benefits. For retroactive compliance, managers must adopt the required formula and reprocess all applicable claims back to January 1, 2026, with at least $9 per claim in dispensing fees; this option does not replace future fee requirements.

Sponsors & Cosponsors

Sponsor

  • Jason Brian DeWitt

    Republican • House

Cosponsors

  • Michael Charles Echols

    Republican • House

Roll Call Votes

All Roll Calls

Yes: 375 • No: 0

Senate vote • 5/31/2026

Conference Committee Report read; adopted by a vote of 35 yeas and 0 nays.

Yes: 35 • No: 0

House vote • 5/31/2026

Conference Committee Report read, roll called, yeas 93, nays 0. The Conference Committee Report was adopted.

Yes: 93 • No: 0

House vote • 5/26/2026

Read by title, roll called, yeas 99, nays 0, Senate amendments rejected, conference committee appointment pending.

Yes: 99 • No: 0

Senate vote • 5/19/2026

Rules suspended. Read by title, passed by a vote of 34 yeas and 0 nays, and ordered returned to the House. Motion to reconsider tabled.

Yes: 34 • No: 0

House vote • 4/21/2026

Read third time by title, amended, roll called on final passage, yeas 102, nays 0. Finally passed, title adopted, ordered to the Senate.

Yes: 102 • No: 0

House vote • 4/9/2026

Read by title, substitute title adopted, lies over in the same order of business, substitute for HB No. 866 reported by the Committee on Insurance

Yes: 12 • No: 0

Actions Timeline

  1. Signed by the Governor. Becomes Act No. 913.

    6/12/2026House

  2. Effective date: 06/12/2026.

    6/12/2026House

  3. Sent to the Governor for executive approval.

    6/4/2026House

  4. Enrolled and signed by the Speaker of the House.

    6/1/2026House

  5. Signed by the President of the Senate.

    6/1/2026Senate

  6. Conference Committee Report read, roll called, yeas 93, nays 0. The Conference Committee Report was adopted.

    5/31/2026House

  7. Notice House adopted the Conference Committee Report.

    5/31/2026Senate

  8. Conference Committee Report read; adopted by a vote of 35 yeas and 0 nays.

    5/31/2026Senate

  9. Notice of Senate adoption of Conference Committee Report.

    5/31/2026House

  10. Conference committee report received.

    5/29/2026Senate

  11. Conference Committee report received. Lies over under the rules.

    5/29/2026House

  12. Scheduled for floor debate on 05/31/2026.

    5/29/2026House

  13. House conferees appointed: Dewitt, Firment, and Miller.

    5/27/2026House

  14. Notice House Conference Committee members appointed.

    5/27/2026Senate

  15. Read by title, roll called, yeas 99, nays 0, Senate amendments rejected, conference committee appointment pending.

    5/26/2026House

  16. Notice House rejected the Senate amendments.

    5/26/2026Senate

  17. Senate conference committee members appointed: Talbot, Bass, and Harris.

    5/26/2026Senate

  18. Notice of Senate conferees appointed.

    5/26/2026House

  19. Scheduled for concurrence on 05/26/2026.

    5/25/2026House

  20. Received from the Senate with amendments.

    5/20/2026House

  21. Rules suspended. Read by title, passed by a vote of 34 yeas and 0 nays, and ordered returned to the House. Motion to reconsider tabled.

    5/19/2026Senate

  22. Reported without Legislative Bureau amendments. Read by title and passed to third reading and final passage.

    5/13/2026Senate

  23. Read by title and referred to the Legislative Bureau.

    5/12/2026Senate

  24. Reported favorably.

    5/11/2026Senate

  25. Senate Committee amendments read and adopted.

    5/7/2026Senate

Bill Text

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